Fear of passing out when observing bloody procedures or unresponsive patients

[PotGoblinsales10]

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Every time there is an unresponsive patient that needs to be intubated, I feel an intense fear of passing out. That is literally all I can think of. I can't focus on my job as well as I'm hoping that I won't pass out.

If I were to pass out, it would be so embarrassing and word would get out to the entire hospital of what happened. No scribe has ever passed out before and I'd be the first.

Sometimes, I would approach the door of the room in case I feel lightheaded and walk out, take a breath and walk back in.

ALL I COULD THINK OF IS PASSING OUT! I don't know what to do or how to handle this. This makes me worry about how I'm going to cope as a doctor or in medical school?

Imagine I am the only attending doctor and I pass out?! I'm only a scribe and passing out terrifies me.

What's worse is that I understand that the patient cannot feel anything and is not in pain. I understand that very well, but, I'm not nervous about what is happening to the patient, I am nervous that I would pass out.

Example: Right after we called a patient dead and nurses were going to prepare cleaning the area, I walked into the room by myself to see how I would feel: NOTHING. I'm not afraid of anything and I am completely comfortable being alone with a patient with his guts spilled on the table, pools of blood everywhere, and his throat wide open from the cricothyrotomy. Just a few minutes ago, I felt like I was going to pass out, yet when I'm alone I feel fine even though I could still pass out. This only happens when I am in a room full of people. When I am alone, I feel fine.

I fear that I will not overcome this and will dread being afraid of passing out as an attending. I want to do emergency medicine, but I think if I don't overcome this, I'm going to be in a lot of trouble.

 

[AllBleedingStops]

No scribe has ever passed out before and I'd be the first.

"At your facility"

I don't know what to do or how to handle this.

Exposure.

 

[FroYoOreo]

Potentially a panic disorder. See a psychologist and do exposure therapy.

 

[RangerBob]

Plenty of scribes have passed out.

A number of my colleagues passed out in the OR back in medical school--some were interested in (and matched into) surgery. They weren't shunned for what is an uncontrollable physiologic reaction. I had to excuse myself while scrubbing in on my first case in OB-Gyn because I saw I was about to pass out. The surgeons and nurses were polite and let me step back from the table and sit on a stool for a bit. I never felt faint after that.

It's unfortunate (but necessary), but time does help desensitize you to this kind of thing.

It could be you're really psyching yourself out and this is more driven by the mind. If you've already had a lot of exposure and it's still going on/getting worse, it could be worth talking with someone. If it's getting in the way of you doing your job, that's when it's worth seeing someone. If you're a student, you typically have access to free counseling through student health.

Make sure you're getting enough fluids/food. You can still drop your BP and faint, but if hydrating well is better than not hydrating.

 

[frog301]

Try watching videos on YouTube that you feel you wouldn't be able to handle in real life! That way it's in a controlled environment, and you can get more exposure without being there in person. I felt the same way for open surgery, but I felt better after watching a couple videos to get used to what I was going to see.

 

[PotGoblinsales10]

Yeah, the fact that the focus of your worry is passing out and not the procedure itself seems like it's an anxiety disorder type deal. Therapy could be really helpful for this.

Also, I know med students who are going into surgery who have passed out in the OR before. It feels embarrassing, but it's really not that big of a deal. Happens to a lot of people, and I've never heard anyone get made fun of for it. If you do feel woozy, it's always okay to take a step back and sit down, take a few deep breaths, grab some water, etc. Nobody will fault you for that.

I agree. I have no problem with the blood or patient's themselves, but I have a problem with how others would perceive me if I did pass out.

Just yesterday, we had a dead patient after cricothyrotomy and a pool of blood nearby. During the intervention when everyone was in the room, I was terrified of passing out and couldn't stop thinking about it. But again, I went to see the patient while CNAs were cleaning her up, this time, even more blood --and I felt fine.

 

[yersinia_pestis]

One of my professors, a highly-respected oncologist, passed out when they were performing their first bone marrow biopsy.

Life happens. You definitely wouldn’t be the first. You wouldn’t be the last. Our school actually gave us a brief overview of the locations and times we may pass out during med school.

But with the amount of distress the thought is causing you, a brief course of therapy might help. Then again, if you don’t want to go that route, just keep in mind it happens to a TON of people in medicine.

Best of luck!